J Korean Soc Spine Surg.  2018 Jun;25(2):69-73. 10.4184/jkss.2018.25.2.69.

Hydrocephalus as a Complication of Durotomy during Cervical Laminoplasty: A Case Report

Affiliations
  • 1Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, Korea. firekimdo@gmail.com

Abstract

STUDY DESIGN: Case report.
OBJECTIVES
We report a case of hydrocephalus as a complication of durotomy during cervical laminoplasty. SUMMARY OF LITERATURE REVIEW: Hydrocephalus is a very rare complication of cervical laminoplasty.
MATERIALS AND METHODS
A 72-year-old man had an incidental durotomy during cervical laminoplasty. The dural leak was repaired by secondary surgery. However, the patient continued to complain of headaches and developed confusion and drowsiness. A computed tomographic scan of the brain showed hydrocephalus. After insertion of a lumbar drain, the patient experienced a temporary improvement in the neurologic symptoms. After 6 months, the neurologic symptoms recurred and a ventriculoperitoneal (VP) shunt was placed.
RESULTS
After placement of the VP shunt, the neurologic symptoms improved significantly.
CONCLUSIONS
If a patient shows deterioration of neurologic symptoms after an incidental durotomy, surgeons should consider the possibility of hydrocephalus.

Keyword

Hydrocephalus; Durotomy; Cervical laminoplasty

MeSH Terms

Aged
Brain
Headache
Humans
Hydrocephalus*
Laminoplasty*
Neurologic Manifestations
Sleep Stages
Surgeons

Figure

  • Fig. 1. Preoperative computed tomographic (CT) scan of the cervical spine. (A) A sagittal CT scan shows segmental ossification of the posterior longitudinal ligament (OPLL, arrowheads) spanning from C4 to C5. (B) An axial CT scan at C4 shows encroachment of the spinal canal by the OPLL mass (arrow).

  • Fig. 2. Preoperative T2-weighted magnetic resonance imaging (MRI) scan of the cervical spine. (A) A sagittal MRI scan shows increased cord signal intensity (arrow) at C4-C5. (B) An axial MRI scan shows central canal stenosis at C4-C5.

  • Fig. 3. T2-weighted sagittal magnetic resonance imaging shows adequate decompression and subcutaneous fluid collection.

  • Fig. 4. Computed tomography shows lateral ventricular dilation.

  • Fig. 5. Computed tomography 30 days after ventriculoperitoneal shunt placement shows normal ventricular morphology.


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